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· Le nom, prénom, date de naissance du patient, date de prélèvement· Le nom et adresse du praticien· Les ATCD médicaux éventuels sont nommées (important de préciser si il y a risque de transmission de pathogènes type VHC, VIH car l’échantillon aura un traitement spécial)· Les renseignements cliniques mentionnant le siège exact du prélèvement (=lieu), les dimensions de la lésion ; un schéma est joint
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